LISA RAE BLANTON

JEFFERSON, WI
NPI1548362056
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: WI  1265-154)
Enumeration Date2006-09-04
Last Update Date2007-07-08
Business Address
Mrs. LISA RAE BLANTON MS/CCC-SLP
N3995 ANNEX RD
JEFFERSON, WI 53549-9618
Phone number: 920-674-7386
Mailing Address
Mrs. LISA RAE BLANTON MS/CCC-SLP
W2579 HALE RD
NEOSHO, WI 53059-9522
Phone number: 920-625-3147
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